October 2019

From the

President’s Desk

Happy PA Week to all my

colleagues in NH!

Healthcare is changing rapidly and the

NH Society of PAs is at the forefront of

keeping our profession prepared for

these changes. Some NH PAs may be

complacent to the rules and regulations

that govern the way we practice, often

because many of us are satisfied with

our careers. However, other PAs are

facing real challenges to employment.

Primary Care, for instance, is an area

with an obvious need for more PAs, yet

few are hired in the field. An increasing

number of hospital-employed

physicians in NH push back on taking

responsibility for “supervising” PAs. I

believe this has created a situation

where some PAs are waiting up to 6

months to get a job after PA school, yet

it takes several months for patients to

get an annual physical. With the

expected shortage of primary care

physicians in the coming years, patient

access will only get worse.

Our biggest goal this fall and into 2020

is to eliminate the administration

burden on physicians so patients have

more access to PAs. Please tell your

colleagues the NHSPA legislative

committee is putting in a ton of hours

to work with the AAPA, NH

legislators, NH lobbyists, and others to

make changes to PA legislation.

I understand many PAs may not have

the time to get involved, but EVERY

NH PA should be aware of the effort

being put in and recognize this by

becoming a member to NHSPA.

Priscilla Marsicovetere, JD, PA-C, Editor

Please submit correspondence and article

submissions to

marsicoveterep@franklinpierce.edu.

Ready, Set, Precept! By Craig Hricz, MPAS, PA-C, Associate Professor of Physician Assistant Studies, Manchester MCPHS

Last year the Centers for Medicare and Medicaid Services (CMS) announced that physicians

would be allowed to utilize medical student H&P documentation as part of their own rather than

having to repeat what can be a tedious and time-consuming process. The physician is still

required to have verified the details with the patient directly and is solely responsible for any

medical decision making. Prior to this, the preceptor was only allowed to use the student review

of systems as well as family and social histories. By removing this added administrative burden

on the provider, CMS is essentially promoting three things: 1) encourage more providers to

become preceptors, 2) earlier student understanding and accountability of their future roles as

sole practitioners, and 3) improved efficiency of patient care.

Unfortunately, the bill left out the same loosening of regulations for both PA and NP precepting

of midlevel provider students. Through the persistent efforts of the Physician Assistant

Education Association (PAEA) and others, the inclusion of “all” preceptors for PA and NP

student-provided documentation will be voted on this October. The decision should be

announced by early November and if passed, it will go into effect on January 1, 2020.

This is potentially good news for PA

education. With 246 and counting PA

schools, the need for preceptors is great.

Ideally, this reduction in administrative

burden on the provider will encourage those

who have been reluctant to do so to this

point. Teaching good quality

documentation during a student’s didactic

training is a significant challenge. Mock

EMRs and SOAP notes are a start, but

nothing can replace the experience of being

responsible for doing this in the clinical

environment on real patients combined

with heightened scrutiny and feedback

from the preceptor who is relying on the

student’s accuracy and completeness to

complement their own interaction. This

combination along with shared clinical

decision-making and application of didactic year content is what ultimately turns the individual

from a student into a provider and future colleague.

With National PA Week coming October 6-12, give back to the profession. Reach out to a

nearby PA program and offer to precept if you don’t already. Recall those who did the same for

you when you were a student and the impact they made. For those who already precept, thank

you! Hopefully these proposed changes are passed and make your precepting even more

rewarding by reducing redundancy and allowing more time with your patients.

Initiatives like this require personal involvement at state and national levels. Consider what you

can do to promote the profession wherever, whenever possible.

Keeping New Hampshire PAs informed, engaged and connected.

The PAEA Preceptor Orientation Handbook is available to members

of PAEA. Go to https://paeaonline.org/publications/preceptor-

handbook/ to obtain a copy, as well as other useful information in

precepting.

2

Happy

PA Week

2019!!!

Every year from October 6-12, we

celebrate National PA Week,

which recognizes the PA

profession and its contributions to

the nation’s health. This week is

also an opportunity to raise

awareness and visibility of the

profession.

How will you celebrate PA Week

2019? An announcement on social

media? Host a community health

event? Write an op-ed and submit

to your local paper? Participate in a

PA Student Service event?

However you choose, be sure to

celebrate the week! You stand on

the shoulders of those who came

before you, all the way back to

those first PAs who graduated from

Duke University in 1967. Our

profession has progressed leaps

and bounds since that time … and

we are still moving forward,

growing, thriving, providing high-

quality healthcare for the nation.

Now, that is truly something to

celebrate!

Happy PA Week!

https://www.aapa.org/events/pa-week/

Legislative Proceedings By Linda Martino, MPAS, PA-C, Manchester MCPHS

On July 18, 2019, the PA students on the Manchester MCPHS campus

welcomed State Senator Tom Sherman and Mike Padmore of the NH

Medical Society. Both were instrumental in passing a PA bill crafted by

the AAPA and NH Society of PAs. Governor Sununu signed the bill on

the same day. The bill, SB225, allows greater access to mental health

services for the people of NH by lifting some of the barriers to PA

practice. Laura Ekstrand, PA-C provided essential testimony in support of

the bill. The invited guests were celebrated with a potluck lunch and cake.

Senator Sherman and Mr. Padmore encouraged the students to continue

their advocacy for the PA profession. Several NH Society of PA board

members were present.

In the current legislative session, we are moving forward with two

additional bills. The first bill allows PAs to sign the POLST form which

Senator Sherman is sponsoring. The second bill will further decrease PA

practice barriers and allow increased access to care for patients. This

second bill also states that PA license renewal would be biennial,

replacing the current annual renewal. AAPA and NHSPA have worked

together to create these bills. NHSPA recently submitted a grant

application to AAPA to help with our work on the PA practice bill. This

legislative work takes time and money and the grant would help fund our

initiative. So, while we applaud our successes to date, we remain vigilant

in addressing various other issues facing our profession. □

3

NHSPA Board of

Directors

Dagan Cloutier, President

Steven Alexakos, Vice

President

Rosanne Washington, Secretary

Deanne Chapman, Treasurer

Members at Large:

Linda Martino

Beth Geralds

Craig Hricz

Brenda Scronce

Contact us:

PO Box 10743

Bedford, NH 03110

nhspa.admin@gmail.com

The Unique Edge of PA Education in New Hampshire By Michael Casella, PA-S, MCPHS ‘20

We all entered PA school with essentially one goal in mind: to come out the other side with a

strong foundation of medicine upon which to build a career. Starting out, few of us knew just

how much more there was to learn. During the first week of classes, we were introduced to the

concept of Optimal Team Practice. Little by little, we learned what it takes to make this model a

success and just how much hard work goes on behind the scenes to ensure so.

Being a state with only two PA schools, students at MCPHS and Franklin Pierce University have

the unique opportunity to participate in some of this hard work through involvement with

organizations like NHSPA. From events with the legislature, to meetings with Senators,

Representatives, and professional organizations, students have the opportunity to see first-hand

how accessible and important advocacy for the Physician Assistant profession is in New

Hampshire.

In September 2019, first year students at MCPHS received a guest lecture from Mike Padmore,

the Director of Advocacy with the New Hampshire Medical Society. He discussed New

Hampshire’s unique political system, upcoming bills, and stressed the importance of

involvement through professional organizations like NHSPA. His talk continued to spark the

students’ enthusiasm to get involved with advocacy early in their careers. As students and the

next generation of Physician Assistants in New Hampshire, we have an obligation to stay

informed and get involved to keep pushing for progress in our profession. □

Nov. 15: NH

Orthopaedic

Society CME &

Meeting,

Bretton Woods

Nov. 15-17:

MAT training

and NHMS

Annual

Meeting

Bretton Woods

Contact

Joy Potter

603-224-7083 for

more information

CME

Credits

The Conference

Corner

Please join us for the next NHSPA meeting

Tuesday, October 8, 2019 Manchester MCPHS Campus